Lyme arthritis
| Classification according to ICD-10 | |
|---|---|
| A69.2 + | Lyme disease Erythema chronicum migrans due to Borrelia burgdorferi |
| M01.2 * | Arthritis in Lyme disease |
| ICD-10 online (WHO version 2019) | |
In the Lyme arthritis is a special form of a bacterial arthritis ( arthritis ), which after an inadequate treatment in the 3rd stage of Lyme disease may occur in well one-tenth of the patients.
Symptoms
Usually it is monarthritis (involvement of a single joint, usually a knee joint ) or oligoarthritis (involvement of several joints), rarely polyarthritis (involvement of many joints) with chronic inflammatory joint effusions .
diagnosis
Lyme arthritis can be diagnosed if arthritis is otherwise unexplained and evidence of infection with Borrelia burgdorferi . A score can be used for clinical diagnosis in children and adolescents, adding up the following points: episodic arthritis (+4 points), joint pain before arthritis (−3 points), age at onset of the disease (+0.3 × age in years as points), beginning in the knee joint (+2 points), previous tick bite (+2 points), number of affected joints (−0.25 × number of joints). Values above 6 make Lyme arthritis probable, values below 2.5 exclude it with a high degree of probability; values in between require further evaluation.
Laboratory detection is difficult and rarely succeeds through culture or polymerase chain reaction from the joint punctate (which is usually obtained to rule out other bacterial arthritis), and through the indirect route of the serum antibodies , which rarely allow reliable statements about the disease activity.
therapy
Like the other manifestations of borreliosis, Lyme arthritis can be successfully treated with consistent antibiotic therapy with doxycycline , even though many cases have reported spontaneous cessation of the symptoms. Even with antibiotic therapy, arthritis often only improves with a delay of up to three months.
literature
- S1- Lyme arthritis guideline of the German Society for Child and Adolescent Medicine (DGKJ). In: AWMF online (as of 2013)
Web links
- Answers to frequently asked questions (PDF; 132 kB)
